The U.S. Department of Health and Human Services (HHS) issued a rule on July 31, 2014, finalizing Oct. 1, 2015, as the new compliance date for healthcare providers, health plans, and healthcare clearinghouses to transition to ICD-10, the tenth revision of the International Classification of Diseases. We’re continuing to move forward with our planned testing with certain providers and clearinghouses in order to meet the federal compliance date. We are not able to accept ICD-10 codes on claims until Oct. 1, 2015. Claims sent using ICD-10 codes prior to the new compliance date will be returned.
Important: Based on the recent delay, Premera will continue to accept the former 1500 Health Insurance Claim Form (version 08/05) through Sept. 30, 2015. Please take this opportunity to use up the forms you have on hand prior to Sept. 30, 2015. Effective Oct. 1, 2015, Premera will only accept claims submitted on the revised form (version 02/12).
The International Classification of Diseases (ICD-10) is a system that facilitates a statistical classification of disease published by the World Health Organization and is one of several means for reporting procedures performed in acute care facilities.
ICD-10 code sets have been widely-used internationally for more than a decade to report patient health conditions. It also is used for mortality reporting in the United States. The U.S currently uses ICD-9 coding both to report patient health conditions and facilitate claims processing and provider reimbursement.
The U.S. Department of Health and Human Services (HHS) mandated the use of ICD-10 codes in the U.S. on all HIPAA transactions by Oct. 1, 2015, for both reporting and payment of claims. The adoption of ICD-10 coding is delayed to no sooner than Oct. 1, 2015.
For Premera, ICD-10 implementation will impact processes across the company; however, we are prepared. Our implementation planning is well underway, and we will meet the federal compliance date.
Provider awareness and preparedness are crucial in making a smooth transition to ICD-10. Provider offices can minimize impacts if they have anticipated, learned, and prepared for the changes, as well as for the potential setbacks.